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previews",[218,229,234,241],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},427,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Optimizing Levodopa-Carbidopa Intestinal Gel Dosing in Parkinson's","https:\u002F\u002Fyoutu.be\u002F4A0Q_OYMEbI",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},50.13333333333333,"\u003Cp dir=\"ltr\">\u003Cspan>Your patient has their G-J tube, their infusion pump with cassettes containing the medication, and a connector to connect the cassettes to their G-J tube. \u003C\u002Fspan>\u003Cbr>\u003Cbr>\u003Cspan>The initial pump titration is best completed when the patient is not taking any levodopa, so the patient should stop all levodopa the night before their first programming appointment and come to your office in the morning with all supplies.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\"> \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Here is how to calculate their morning dose:\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>(dose of levodopa x 0.8) \u002F 20 = morning dose of LCIG in mL\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>To calculate the continuous infusion dose: \u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Add all doses of levodopa taking during the day – levodopa morning dose = total levodopa daily dose\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Total levodopa daily dose \u002F 20 = gel dose\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Gel dose \u002F 16 h = continuous infusion dose\u003C\u002Fspan>\u003C\u002Fp>\u003Cp> \u003C\u002Fp>\u003Cp>\u003Cspan>You should program the pump and start the morning dose with your patient. While waiting to assess improvement, you should review the following with the patient:\u003C\u002Fspan>\u003C\u002Fp>\u003Col>\u003Cli dir=\"ltr\">\u003Cspan>Wound healing\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>The daily routine of washing the tube\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>Cleaning the stoma\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>Hooking up the pump\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>Removing the pump for showers\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>Removing the pump for sleep\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>How to give an extra dose for OFF time\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>How to pause the pump when bothersome dyskinesias occurs\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>What to do if the tube or pump malfunctions\u003C\u002Fspan>\u003C\u002Fli>\u003Cli dir=\"ltr\">\u003Cspan>What to use for nighttime symptoms\u003C\u002Fspan>\u003C\u002Fli>\u003C\u002Fol>\u003Cp dir=\"ltr\">\u003Cspan>If the morning dose takes longer than 45 minutes to take effect then this dose likely needs to be increased.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Watch the video for example calculations and more!\u003C\u002Fspan>\u003C\u002Fp>",{"type":235,"data":236},"cta",{"readDurationInSeconds":237,"text":238,"buttonText":239,"buttonUrl":240},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":242},{"readDurationInSeconds":243,"text":244},13.333333333333334,"\u003Cp dir=\"ltr\">\u003Cspan>Explore cutting-edge Parkinson’s treatments, including device-assisted and lesioning therapies. 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Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":346,"title":301,"size":347,"location":348},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":329,"height":329},{"bucket":305,"key":349},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":351,"title":352,"relativeURL":353,"image":354,"professionLong":355,"profession":356,"weight":358},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":357},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":363,"updated":364,"published":365},1776705362,1776710540,1776710541,{"seo":367,"og":369},{"title":368,"description":213},"Administering levodopa-carbidopa intestinal gel | Medmastery",{"title":368,"description":213,"image":370},{"alt":371,"title":212,"size":372,"location":373},"Image of LCIG pump ",{"width":303,"height":303},{"bucket":305,"key":374},"\u002F2024-01\u002FAdministering levodopa-carbidopa intestinal gel.png",{"id":376,"created":377,"updated":378,"published":377},1020,1706293045,1761682920]